Statistics Belgium, Belgian National Statistical Office

Statistical Direction Demography

Boulevard du Roi Albert II, 16

1000 Brussels Belgium

Data on causes of death (CoD) provide information on mortality patterns and form a major element of public health information.

CoD data refer to the underlying cause which - according to the World Health Organisation (WHO) - is "the disease or injury which initiated the train of morbid events leading directly to death, or the circumstances of the accident or violence which produced the fatal injury".

CoD data are derived from death certificates. The information provided in the medical certificate of cause of death is mapped to the International Statistical Classification of Diseases and Related Health Problems (ICD).

Eurostat's CoD statistics build on standards set out by the World Health Organisation (WHO) in the International Statistical Classification of Diseases and Related Health Problems (ICD).

The regional breakdown is based on the Nomenclature of Territorial Units for Statistics (NUTS 2).

Classification and updates applied by years

Public Health

Concepts and definitions are described in the Commission regulation (EU) No 328/2011 in articles 2 and 3.

Legally registered residence (of the mother in the case of stillbirths)

Fœtal death with at least 500 g, or if the weight is unknown, at least 22 weeks.

Weight and gestational age are collected.

The statistical units are the deceased persons and the stillborns, respectively.

See details next in sub-sections.

Neonates of non-resident mothers are not considered residents.

Non-residents are transmitted

Residents dying abroad are no longer included from 2018 onwards. The cause of death is not recorded and coded R99.

Belgium.

2011-2021

Not applicable.

The unit is number.

2021

CoD data was submitted to Eurostat on the basis of a gentleman's agreement established in the framework Eurostat's Working Group on "Public Health Statistics" until data with reference year 2010.

A Regulation on Community statistics on public health and health and safety at work (EC) No 1338/2008 was signed by the European Parliament and the Council on 16 December 2008. This Regulation is the framework of the data collection on the domain.

Within the context of this framework Regulation, a Regulation on Community statistics on public health and health and safety at work, as regards statistics on causes of death (EU) No 328/2011 was signed by the European Parliament and the Council on 5 April 2011. 

CoD data according to this regulation is submitted to Eurostat since reference year 2011.

Data are shared with partners due to contracts (Public Insitutions, University researchs).

Regulation (EC) No 223/2009 on European statistics (recital 24 and Article 20(4)) of 11 March 2009 (OJ L 87, p. 164), stipulates the need to establish common principles and guidelines ensuring the confidentiality of data used for the production of European statistics and the access to those confidential data with due account for technical developments and the requirements of users in a democratic society.

No direct identification.

Not applicable.

Not applicable.

In line with the Community legal framework and the European Statistics Code of Practice Eurostat disseminates European statistics on Eurostat's website (see item 10 - 'Accessibility and clarity') respecting professional independence and in an objective, professional and transparent manner in which all users are treated equitably. The detailed arrangements are governed by the Eurostat protocol on impartial access to Eurostat data for users.

Annual.

Releases on-line.

Tables annualy available on statbel.fgov.be

https://statbel.fgov.be/en/themes/population/mortality-life-expectancy-and-causes-death/causes-death

No micro-data online disseminated.

The user has to submit an official request. This is analysed by the Statbel-DPO committee which grants access to the data or not.

Nothing.

Documents for COD from Eurostat.

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Not available.

The causes of death data are based on a regulation, which defines scope, definitions of variables and characteristics of the data.

Not available.

Research Institutes,  Universities, Students, Public Government agencies, Private, Commission services and Business companies.

Not available

All the compulsory variables are transmitted to Eurostat.

1. For mandatory variables:

 100%

2. For voluntary variables:

3. For additional variables:

• External CoD

• Place of occurrence for external CoD

• Activity for external CoD

Good and improving.

Not applicable. Data collection is from administrative sources.

Not applicable.

See details in sub-sections.

Not applicable.

Not applicable.

Not applicable. Data collection is from administrative sources.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

From data collection with reference year 2011 onwards, Eurostat asks for the submission of final data at national and regional level and related metadata for the year N at N+24 months, according to the Implementing Regulation (EC) No. 328/2011, Article 4.

Stillbirths were transmitted at N+24

Final General file was transmitted at N+24.

In Belgium, two different federate entities code the underlying cause of death with the ICD-10 codes and rules. But their coding practices are slightly different. That can affect the national comparability.

Not applicable.

Note that due to the fact that 2011 data is the first data collection with a legal basis (and few changes in the requested variables and breakdowns), the data between 1994-2010 and starting from 2011 are not always comparable (in part due to the different groupings of causes of deaths). Moreover time series for data on stillbirths starts in 2011 and no information on previous data is available.

Since 2010, Statistics Belgium includes the deaths abroad in the national statistics (with R99 code, because the death certificate is absent). This was not the case before 2010.

Since 2018, Statistics no longer includes the deaths abroad following Eurostat's indication. 

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See details in sub-sections.

Not applicable, only annual data are available.

Not applicable.

Small differences between the coding practices in the two responsible federate entities may occur.

The cost and burden of the data collection is reduced by using validation and dissemination IT tools.

No Belgian policy on CoD revision.

Any data revision practice.

Not applicable.

Deaths certificates (two models) compiled and coded by the Federate entities.

Annual. Certificates are sent to the Federate entities mensually and the raw data files are sent to Statistics Belgium annualy.

See details in sub-sections.

Table on certification (Percentage)

For BR & FL

Stillbirths and infant deaths are registered on the same certificate, but this certificate differs the one used for other deaths. The causes of death, however, are presented and coded in the same way for all deaths ( up to 2011). Neonates are registered with a certificate dedicated to all the infant deaths and stillbirths. The dates (with hours) of birth and deaths are registered and used to identify the neonates

Population National Register is used to validate the coverage of the residents deaths.

Description of coding procedure (central level, distributed among other bodies, etc.):

Coding is done at a central level in each of the 3 regions: Flanders, Brussels and Wallonia (since 1993)

Description of the procedures to detect errors (i.e.errors such as potential inconsistency in the death certificate or error due to mistake when filling the deaths certificates):

FL &BR: complex system: data-entry checks (build in, in Iris,…), check of all certificates containing a medical term that does not figure in the dictionary (FL only), final error control reports containing unlikely, inconsistent or rare outcomes of the UC.

Description of the measures taken in order to solve detected errors:

FL &BR: Queries to the municipalities, to the certifying MD’s and, for external causes of death, to the juridical instances

Coding performed by a certifier: no

Estimation of the percentage of autopsy from which information is available for coding:

 FL &BR: Less than 0.5% of the deaths

Description of double coding exercises and rate of codification errors for underlying cause of death:

FL &BR: coding is repeated by the most experienced coder and physician on all certificates detected in the control reports.

ICD codes for the underlying cause (% of the Total)

Unknown country/region (%) for residents and non-residents who died in the country

A few deaths are not registered in the deaths certificate and a few other early deaths are not registered in the National Population Register. Coupling the two sources limits the possible coverage error.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

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